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Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Chapter 21
Cardiovascular System Function, Assessment, and Therapeutic
Measures
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
The Heart In Mediastinum Pericardial Sac: Three Layers
Fibrous Pericardium Parietal Pericardium Visceral Pericardium (Epicardium) Serous Fluid Between Inner Layers
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Anterior Heart View
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Frontal Heart View
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiac Structure and Vessels Four Chambers
Right/Left Atrium, Right/Left Ventricle
Cardiac Layers Epicardium, Myocardium, Endocardium
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiac Structure and Vessels (cont’d)
Coronary Arteries Valves
Tricuspid, Pulmonic, Mitral, Aortic
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Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Blood FlowVena Cava » Right Atrium» Tricuspid »
Right Ventricle» Pulmonic » Pulmonary
Artery » Lungs » Pulmonary Veins» Left
Atrium » Mitral » Left Ventricle» Aortic
Valve » Aorta
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiac Conduction SA Node AV Node Bundle of His Right and Left Bundle Branches Purkinje Fibers
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiac Output Amount of Blood Ejected from the Left
Ventricle in 1 Minute Stroke Volume x Heart Rate = CO
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Nervous System Regulation of the Heart
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Hormones and the Heart Epinephrine
Increases Heart Rate Force of Contraction Cardiac Output Systolic BP
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Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Hormones and the Heart (cont’d) Aldosterone
Regulates Sodium/Potassium
Atrial Natriuretic Peptide Excretes Sodium
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Blood Vessels Arteries Veins Capillaries
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Structure of Blood Vessels
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Blood Pressure Blood Force Against Blood Vessel Walls Normal
Systolic <120 mm Hg Diastolic <80 mm Hg
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Renin-Angiotensin-Aldosterone Mechanism
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Pathways of Circulation Pulmonary Systemic
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Aging and the Cardiovascular System
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Aging and the Cardiovascular System (cont’d)
Atherosclerosis Arteriosclerosis Blood Pressure Increases Vein Valves More Incompetent Heart Muscle Less Efficient Dysrhythmias Common
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiovascular Disease Number 1 Killer Healthy Lifestyle
Smoking Cessation Dietary Fat Reduction Two Servings of Fish Weekly Exercise
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiovascular Disease (cont’d)
Go Red for Women American Heart Association’s Nationwide
Movement to Celebrate the Power Women Have to Band Together to Wipe Out Heart Disease
Color Red and Red Dress Linked with This Ability
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiovascular Assessment Health History Physical Assessment Diagnostic Studies
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Health History Symptoms – WHAT’S UP? Allergies Past Medical History Medications Family History Health Promotion Methods
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Physical Assessment Vital Signs
Blood Pressure Pulse Respirations Temperature
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Physical Assessment (cont’d) Inspection
Oxygenation, Skin Color Extremities: Hair , Skin, Nails, Edema, Color JVD Capillary Refill Clubbing
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Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Clubbing
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Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Physical Assessment (cont’d) Palpation
Point of Maximum Impulse Extremity Temperature
Poikilothermy
Edema Homans’ Sign
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Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Edema
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Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Homans’ Sign
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Physical Assessment (cont’d) Auscultation
Heart Sounds S1 S2 S3 S4
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Heart Sounds
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Physical Assessment (cont’d) Auscultation (cont’d)
Murmurs Pericardial Friction Rub
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Diagnostic Studies Joint Commission
National Patient Safety Goal Improve Accuracy of Patient Identification
Use at Least Two Patient Identifiers (Neither Patient's Location) Whenever Collecting Laboratory Samples or Administering Medications or Blood Products
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Diagnostic Studies Joint Commission National Patient Safety Goal (cont’d)
Use Two Identifiers to Label Sample Collection Containers in Presence of Patient
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Diagnostic Studies Joint Commission
National Patient Safety Goal (cont’d)
Immediately Prior to Any Invasive Procedure, Conduct Final Verification Process to Confirm Correct Patient, Procedure, Site, and Availability of Appropriate Documents
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Noninvasive Diagnostic Studies
Chest X-Ray CT Scan Magnetic Resonance Imaging
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Electrocardiogram Records Cardiac Electrical Activity
Signal-averaged ECG Risk for Ventricular Dysrhythmias
Ambulatory Electrocardiogram Monitoring Holter Monitoring
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Echocardiogram Ultrasound Records Motion
Heart Structures Valves Heart Size, Shape, Position
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Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Transesophageal Echocardiogram
Probe in Esophagus Clearer Picture NPO Until Gag Reflex Returns
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Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Exercise StressTest Cardiac Stress Test
Cardiac Response to Exercise and Increased Oxygen Needs
Peripheral Vascular Stress Test Vascular Response to Walking
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiac Stress Test
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Noninvasive Diagnostic Studies
Plethysmography Diagnoses Deep Vein Thrombosis/Pulmonary
Emboli/Peripheral Vascular Disease
Pressure Measurement BP Readings Along Extremity
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Noninvasive Diagnostic Studies (cont’d)
Arterial Stiffness Index Atherosclerosis/Cardiovascular Disease
Tilt Table Test Lying to Standing BP and HR
Doppler Ultrasound Impaired Blood Flow Reduces Sound Waves
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Radioisotope Imaging Radioisotopes IV, Gamma Camera Scan Detects Cardiac Ischemia/ Damage/
Perfusion Thallium Imaging Technetium Pyrophosphate Scan Technetium 99m Sestamibi MUGA Scan Positron Emission Tomography
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Blood Studies Blood Lipids
Triglycerides, Cholesterol, Phospholipids
hs-CRP Homocysteine Cardiac Biomarkers
Creatine Kinase, Troponin, Myoglobin
Magnesium
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Diagnostic Studies Joint Commission
National Patient Safety Goal Improve Effectiveness of Communication
Among Caregivers For Orders/Telephonic Reporting of Critical
Test Results, Verify Complete Order/Test Result by Reading Back Complete Order/ Test Result to Person Giving it
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Invasive Studies Angiography Cardiac Catheterization Hemodynamic Monitoring Electrophysiology Study
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiac Catheterization
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Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Pulmonary Artery Catheter
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Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Therapeutic Interventions Exercise: Walking Program Cardiac Rehab Smoking Cessation Balanced Diet, Weight Loss Oxygen
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Therapeutic Interventions (cont’d)
Antiembolism Devices Elastic Stockings Intermittent Pneumatic Compression
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Therapeutic Interventions (cont’d)
Medications Cardiac Glycosides Vasodilators Antihypertensives Antidysrhythmics Antianginals
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Therapeutic Interventions (cont’d)
Medications (cont’d) Anticoagulants Thrombolytics
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Lifestyle and Cardiac Care Risk Factors Support Groups Sexual Activity
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiac Surgery Preparation for Surgery Cardiopulmonary Bypass
Video-assisted Thoracoscope
General Procedure for Cardiac Surgery Minimally Invasive Cardiac Surgery
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiopulmonary Bypass Pump
Copyright © 2011. F.A. Davis Company
Linda S. Williams / Paula D. HopperUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th EditionUnderstanding Medical Surgical Nursing, 4th Edition
Cardiopulmonary Bypass Pump in Use